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What You Should Know About Coronavirus Disease 2019


WPS Health Insurance is actively monitoring the current international and domestic environment for COVID-19 as well as the related risks so we can prepare accordingly. On this page, you’ll find links to information about COVID-19, related news, and information on what WPS is doing to help our customers.

Note: The content below is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

What is COVID-19?

It’s a new coronavirus strain that causes respiratory illness. Originating in Wuhan City, China, the virus has infected thousands of people worldwide and caused deaths. Cases have now been reported around the world. The World Health Organization named the disease caused by the new coronavirus on Feb. 11, 2020. The new name is COVID-19, short for “coronavirus disease 2019.”

What are the symptoms of COVID-19?

Common signs of infection include:

  • Respiratory symptoms
  • Fever
  • Cough
  • Shortness of breath
  • Breathing difficulties

In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure, and death.

People with heart and lung disease or weakened immune systems, as well as infants and older adults, are at higher risk for lower respiratory tract illness.

How is COVID-19 spread?

Human coronaviruses are usually spread from an infected person to others through the air by coughing and sneezing and through close personal contact, such as touching or shaking hands.

Find out more:

  • Wash your hands often with soap and water for at least 20 seconds, especially before eating and after going to the bathroom, blowing your nose, coughing, or sneezing.
  • If you do not have soap and water, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid close contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

Is a COVID-19 test covered by my insurance?

Medicare Part B covers a test to see if you have COVID-19 if you received the test on or after Feb. 4, 2020. You will not be responsible for any out-of-pocket costs.

What if I need to be hospitalized for COVID-19?

Medicare covers all medically necessary hospitalizations.

Who at WPS can I call with questions about COVID-19 and my Medicare supplement insurance plan?

You can call our Customer Support team at 1-888-253-2694 for answers.

Will there be coverage for a COVID-19 vaccine when one becomes available?

Vaccines are an essential and highly effective way to prevent infectious disease in large populations. Unfortunately, a vaccine for COVID-19 is not yet available. If and when a vaccine is developed, it will be covered similar to other vaccines.

Are medical supplies such as masks, gloves, and disinfectants covered?

Most of these supplies are not currently covered by Medicare or insurance plans in general.

Can I use telehealth services to get care for COVID-19?

Due to recent guidance from the Centers for Medicare & Medicaid Services, Medicare and our WPS Medicare supplement insurance plans will cover telehealth benefits through a medical provider (not Teladoc® at this time) for as long as it is covered by Medicare.

Is the COVID-19 test covered under my health plan?

WPS will waive any cost-sharing for laboratory tests related to COVID-19. For some employers, WPS is only the administrator, not the insurer. In these situations, it is the decision of the employer to determine how this will be covered.

The IRS has indicated that a health plan that otherwise satisfies the requirements to be an HSA qualified High-Deductible Health Plan (HDHP) may provide health benefits associated with the testing of COVID-19 without a deductible, or with a deductible below the minimum deductible (self-only or family) for an HDHP. An individual covered by the HDHP will not be disqualified from being an eligible individual because they received COVID-19 testing.

If I need to see a doctor for COVID-19, is that covered?

WPS will waive prior authorization requirements, and cover with no out-of-pocket costs to the customer, COVID-19 diagnostic laboratory testing and health care costs associated with provider visits for testing (e.g., office visits, urgent care visits, hospital visits, emergency room visits, etc.) for all fully insured policyholders and for self-funded plan policyholders where the group has instructed us to provide this coverage. This coverage applies for both in-network and out-of-network providers.

Can telehealth services be used to get care for COVID-19?

In most cases, telehealth services are available to WPS customers and their dependents to answer questions about the virus, evaluate their risk, and provide support by phone or video call if they develop symptoms. Cost-sharing for office visits to determine if COVID-19 testing is needed and the testing itself are waived, which means customers pay no copays, deductibles, or coinsurance. For services not related to COVID-19 testing, Teladoc® is our preferred provider and other telehealth services (such as those offered by provider groups) will be covered based on the terms of the customer's health plan. While self-funded groups with our Freedom Essentials plan will be able to opt out of this coverage, all other self-funded group health plans must opt in to this coverage change. Self-funded groups should get in touch with us right away to ensure they have the telehealth benefit they want for their employees.

  • For WPS Medicare supplement insurance customers: Due to recent guidance from the Centers for Medicare & Medicaid Services, Medicare and our Medicare supplement insurance plans will cover telehealth benefits through a medical provider (not Teladoc at this time) for as long as it is covered by Medicare.
  • Benefit update: For non-HSA-qualified health plans, all copays for Teladoc for any condition will be waived starting in the near future; an announcement will be made on this soon. If a customer has an HSA-qualified HDHP, deductibles and coinsurance will still apply, to avoid jeopardizing their tax-qualified status.

If I may be quarantined, can I get a larger supply of my prescription medications?

There is no change in the way prescription drug coverage is administered. However, we encourage the use of home delivery for medications when available to help maintain social distancing. Early refills are also available. WPS will allow early refills for both 30-day supplies and 90-day supplies of retail and home delivery prescriptions. Note that not all medications are approved for extended supplies and the amount of the refill will vary depending on the number of refills remaining on the prescription.

What is covered if I’m quarantined?

Your WPS health plan covers all medically necessary services based on the terms of your policy. There is no coverage for housing, food, and other items.

What if I need to be hospitalized for COVID-19?

Hospitalizations are covered under the terms of your health plan.

How is WPS Health Insurance handling temporary layoffs, furloughs, shutdowns, or reductions in hours for group health plan customers?

During temporary conditions such as these, WPS will allow employers to retain employees and their dependents on their group health plans as follows:

  • Fully insured employer groups: WPS will waive its requirement for employees to be actively working in order to be eligible for coverage through June 30, 2020, as long as the monthly premium payment is received and at least one employee of the group remains an eligible employee as defined in the group health plan. Coverage must be offered on a uniform, nondiscriminatory basis to all employees.
  • Self-funded employer groups: Groups may opt into this benefit. WPS will waive its requirement for employees to be actively working in order to be eligible for coverage through June 30, 2020, as long as the payment of administrative fees, claims cost, and WPS stop-loss premium is received and at least one employee of the group remains an eligible employee as defined in the self-funded group health plan. Coverage must be offered on a uniform, nondiscriminatory basis to all employees. If WPS is not the client’s stop-loss carrier, we recommend that the client verify coverage for this situation with their stop-loss carrier.

Who at WPS can I call with questions about COVID-19 and my WPS insurance plan?

You can call our Customer Support team using the number on your customer ID card.

Will there be coverage for a COVID-19 immunization when one becomes available?

Immunizations are an essential and highly effective way to prevent infectious disease in large populations. Unfortunately, an immunization for COVID-19 is not yet available. If and when an immunization is developed, it will be covered similar to other immunizations.

Are medical supplies such as masks, gloves, and disinfectants covered?

Most of these supplies are not currently covered by insurance plans in general.

Is the COVID-19 test covered under a customer's health plan?

WPS will waive any cost-sharing for laboratory tests related to COVID-19. For some group health plans, WPS is only the administrator, not the insurer. In these situations, it is the decision of the employer to determine how this will be covered.

The IRS has indicated that a health plan that otherwise satisfies the requirements to be an HSA qualified High-Deductible Health Plan (HDHP) may provide health benefits associated with the testing of COVID-19 without a deductible, or with a deductible below the minimum deductible (self-only or family) for an HDHP. An individual covered by the HDHP will not be disqualified from being an eligible individual because they received COVID-19 testing.

Is a COVID-19 test covered by Medicare or a WPS Medicare supplement insurance plan?

Medicare Part B covers a test to see if a beneficiary has COVID-19 if the person received the test on or after Feb. 4, 2020. Beneficiaries will not be responsible for any out-of-pocket costs.

If a customer needs to see a doctor for COVID-19, is that covered?

WPS will waive prior authorization requirements, and cover with no out-of-pocket costs to the customer, COVID-19 diagnostic laboratory testing and health care costs associated with provider visits for testing (e.g., office visits, urgent care visits, hospital visits, emergency room visits, etc.) for all fully insured policyholders and for self-funded plan policyholders where the group has instructed us to provide this coverage. This coverage applies for both in-network and out-of-network providers.

What if a Medicare beneficiary needs to be hospitalized for COVID-19?

Medicare covers all medically necessary hospitalizations.

Can telehealth services be used to get care for COVID-19?

In most cases, telehealth services are available to WPS customers and their dependents to answer questions about the virus, evaluate their risk, and provide support by phone or video call if they develop symptoms. Cost-sharing for office visits to determine if COVID-19 testing is needed and the testing itself are waived, which means customers pay no copays, deductibles, or coinsurance. For services not related to COVID-19 testing, Teladoc® is our preferred provider and other telehealth services (such as those offered by provider groups) will be covered based on the terms of the customer's health plan. While self-funded groups with our Freedom Essentials plan will be able to opt out of this coverage, all other self-funded group health plans must opt in to this coverage change. Self-funded groups should get in touch with us right away to ensure they have the telehealth benefit they want for their employees.

  • For WPS Medicare supplement insurance customers: Due to recent guidance from the Centers for Medicare & Medicaid Services, Medicare and our Medicare supplement insurance plans will cover telehealth benefits through a medical provider (not Teladoc at this time) for as long as it is covered by Medicare.
  • Benefit update: For non-HSA-qualified health plans, all copays for Teladoc for any condition will be waived starting in the near future; an announcement will be made on this soon. If a customer has an HSA-qualified HDHP, deductibles and coinsurance will still apply, to avoid jeopardizing their tax-qualified status.

If a customer is concerned about being quarantined, can the customer get a larger supply of prescription medications?

There is no change in the way prescription drug coverage is administered. However, we encourage the use of home delivery for medications when available to help maintain social distancing. Early refills are also available. WPS will allow early refills for both 30-day supplies and 90-day supplies of retail and home delivery prescriptions for both fully insured and self-funded groups. Note that not all medications are approved for extended supplies and the amount of the refill will vary depending on the number of refills remaining on the prescription.

What is covered if a customer is quarantined?

Each WPS health plan covers all medically necessary services based on the terms of the policy. There is no coverage for housing, food, and other items.

What if a customer needs to be hospitalized for COVID-19?

Hospitalizations are covered under the terms of the health plan.

How is WPS Health Insurance handling temporary layoffs, furloughs, shutdowns, or reductions in hours for group health plan customers?

During temporary conditions such as these, WPS will allow employers to retain employees and their dependents on their group health plans as follows:

  • Fully insured employer groups: WPS will waive its requirement for employees to be actively working in order to be eligible for coverage through June 30, 2020, as long as the monthly premium payment is received and at least one employee of the group remains an eligible employee as defined in the group health plan. Coverage must be offered on a uniform, nondiscriminatory basis to all employees.
  • Self-funded employer groups: Groups may opt into this benefit. WPS will waive its requirement for employees to be actively working in order to be eligible for coverage through June 30, 2020, as long as the payment of administrative fees, claims cost, and WPS stop-loss premium is received and at least one employee of the group remains an eligible employee as defined in the self-funded group health plan. Coverage must be offered on a uniform, nondiscriminatory basis to all employees. If WPS is not the client’s stop-loss carrier, we recommend that the client verify coverage for this situation with their stop-loss carrier.

Who at WPS can customers call with questions about COVID-19 and their WPS insurance plan?

WPS individual and group health plan customers can call our Customer Support team using the number on their customer ID card. WPS Medicare supplement insurance customers can call our Customer Support team at 1-888-253-2694.

Will there be coverage for a COVID-19 immunization when one becomes available?

Immunizations are an essential and highly effective way to prevent infectious disease in large populations. Unfortunately, an immunization for COVID-19 is not yet available. If and when an immunization is developed, it will be covered similar to other immunizations.

Are medical supplies such as masks, gloves, and disinfectants covered?

Most of these supplies are not currently covered by insurance plans in general.

How does COVID-19 impact the filing of a claim or appeal?

Each Provider Agreement contains provisions related to the timely filing of claims and appeals. In order to allow our Provider partners to focus their efforts on responding to the national health crisis and caring for their patients and our customers, WPS Health Insurance will waive the enforcement of certain Provider Obligations:

  • Timely filing limits will not be enforced for claims submitted between April 1, 2020, and Dec. 31, 2020. This applies to both new claims and claims that were resubmitted due to corrections.
  • Timely filing limits for all provider appeals are waived for the remainder of 2020. Please note that Member Grievances are governed by the customer’s certificate of coverage and are not included in this extension.
  • Providers who had already received Prior Authorization for procedures and services that have been canceled or postponed due to the COVID-19 crisis will be granted an additional 90 days to perform the procedure or service without needing to obtain another Prior Authorization.
  • Are there changes to how telehealth services work?

    We have temporarily expanded our coverage of telehealth and telemedicine services to allow providers to render important healthcare services while protecting both patients and caregiving staff from avoidable exposure to COVID-19. Review our temporary telehealth policy.

    Will customer cost sharing apply to COVID-19 testing?

    Fully insured groups: No, effective March 18, 2020, our individual health plans and our group/employer health plans, including grandfathered and transitional health plans, must cover COVID-19 testing and the visit for testing from in-network and out-of-network providers, with no cost-sharing to our customers. This includes not requiring prior authorizations or other medical management requirements.

    Specifically, we will not apply cost-sharing to:

    • The tests and their administration
    • Items and services provided during an office visit (including a telehealth visit), urgent care visit, or emergency room visits that result in an order for a test or its administration, to the extend they relate to the furnishing or administration of, or evaluation for, the test.
    This change in coverage will not apply to services for the treatment of a positive COVID-19 test result.

    Self-funded groups: For customers on a self-funded plan, the employer will need to make the determination on how COVID-19 testing claims should be adjudicated. The self-funded group (employer) will need to provide WPS with written direction on how to change their plan benefits. If a self-funded group health plan notifies us that they would like to change their benefit plan (e.g., waive the cost-sharing for testing), the group will see an increase in claims costs.

    Will waiving the cost sharing for COVID-19 testing on an HSA-qualified High-Deductible Health Plan (HDHP) disqualify the individual from being able to make tax-favored contributions to an HSA account?

    Fully insured groups: No. On March 11, 2020, the IRS released a notice that allows insurers to provide health benefits associated with the testing for COVID-19 (Coronavirus Disease 2019) without first applying the HDHP's applicable deductible. As stated in the notice, this is true until further guidance is issued.

    Self-funded groups: WPS will make this change to self-funded groups upon receipt of written confirmation.

    What if a practitioner needs to work at a different location?

    Many providers have asked for flexibility in moving practitioners between service locations during the crisis. We have temporarily modified our process to allow practitioners to provide care at any location within the same entity (as defined by a single tax ID), even if that practitioner was not previously registered to that address. Please continue to provide roster updates as normal.

    How does WPS Health Insurance handle practitioners with licenses in other states?

    We acknowledge the CMS 1135 waiver for state licensing, which temporarily allows out-of-state practitioners to provide services if they are licensed in another state. In the State of Wisconsin, organizations must follow the provisions outlined in the Wisconsin Department of Health Services Emergency Orders #16 and #20, found at evers.wi.gov/Documents/COVID19/EMO16-DSPSCredentialingHealthCareProviders.pdf and dsps.wi.gov/Documents/EmergencyOrder20.pdf.

Stimulus check scams

The Internal Revenue Service urges taxpayers to be on the lookout for a surge of scam phone calls and email phishing attempts about the coronavirus, or COVID-19. The schemes are related to the economic impact payments being issued by the U.S. government.

Read the news release

COVID-19 test kits

Beware of solicitors who try to sell you a coronavirus disease (COVID-19) test kit. Legitimate COVID-19 tests are ordered by your attending physician.

Do not give out personal information

If you are called by anyone other than your attending physician, please do not provide personal or health-related information. Never give your bank or credit card information to any solicitor over the phone.

   

Given the rapidly evolving nature of this disease, the above guidance is subject to change.

Is your doctor in your network?


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